There Are 6 Types of Drowning — 4 That You’ve Never Heard of

Would you know when someone is drowning? Most incidences look nothing like you think they would. As summer begins, we wanted to share this surprising info every beachgoer, pool user, and parent needs to know. (Photo: Getty Images)

Once upon a time, there were six distinct types of drowning.

But in 2005, the World Health Organization moved to simplify all types of drowning under the umbrella term drowning, whether or not the incidents are fatal,  emergency medicine physician Darria Long Gillespie — an assistant professor at Emory University School of Medicine — tells Yahoo Health.

But what’s been lost with this change is the basic knowledge of the types of drowning that aren’t as obvious as the hands-flailing-in-the-air, “Help!-I’m-drowning” scenes we see in the movies. Most of us think that drowning is drowning, and our ability to identify each different form has evaporated over the years.

The Six Types of Drowning

In reality, most types of drowning are subtle, quick, and silent. One can happen hours after one has gotten out of the pool, ocean or bathtub. And the most mysterious type of drowning does not even require water in the windpipe. Here’s what drowning can mean, and how it looks across cases.

Wet

Wet drowning is the classic case you imagine when someone mentions drowning. “If you think of what happens when you’re caught underwater and holding your breath, the body eventually inhales liquid,” says Gillespie. “The liquid floods the lungs, harms the lining, and you can’t take in oxygen. This is the most common type.”

Dry

In roughly 10 to 15 percent of deaths by drowning, victims are found with no water in their lungs. “The throat reflexively closed before they hit water, and they died,” says Gillespie. “For a while, though, doctors wondered, does it really exist?”

There was no obvious explanation for dry drowning, although experts have come up with a couple theories. One is that the initial flood of water causes the throat to close up, and victims die by asphyxiation. The other is that victims go into shock upon hitting cold water, the heart stops suddenly, and they go into cardiac arrest.

Silent

Drowning in the movies is a wild event. Arms are flailing, water is splashing, and the victim is calling for help. In reality, drowning is often a very quiet moment. “Any drowning can be silent,” says Gillespie.

“This term simply refers to the fact that there is no warning, and no sounds.” The victim often just slips away, and is found later. Drowning is something Hollywood gets wrong.

Active

That said, there are rare times when a drowning victim is fighting. Active drowning refers to the state of the victim when they’re found in the water. “The person is likely upright, they are treading water, trying to keep themselves above it, and their hands are flailing,” says Gillespie. “They are also likely trying to grasp for the rescuer.”

This whir of motion is actually dangerous for the person attempting to make the rescue, and they must use extra caution in the water. The drowning victim may latch onto a rescuer, and potentially drag him or her underwater.

Passive

When a victim is unconscious — usually in the later stages of a drowning episode — it’s referred to as passive drowning. “They are generally facedown in the water instead of upright,” says Gillespie. “Sometimes they aren’t on top of the water, but floating a bit under the surface, and they are unresponsive.”

Secondary

Most people aren’t aware of secondary drowning, but it can be frightening. “Someone was submerged, they did not die, came out of the water and initially seemed fine — and that’s what is so dangerous,” says Gillespie.

While under the water, secondary drowning victims inhale a small amount of water, which damages the lining of the lungs and causes inflammation. “If the lung lining is damaged, it can’t transmit oxygen, and the body is also leaking fluid into the lungs as a result of the inflammation,” Gillespie says. This fluid accumulates in the hours following a near-drowning episode, and the victim can slowly and silently drown.

Related: Here’s How This Boy Miraculously Survived Near-Drowning After 1 Hours, 41 Minutes of CPR

Especially with children, parents should watch for the signs of secondary drowning for around 24 hours after a near-drowning episode. “When an adult is drowning, they can keep their head above water,” Gillespie says. “When it’s a child, they can’t always keep their head above the water.”

If your child experiences a near-drowning, or is sucked under the surface and inhales water, look for the signs. These include excessive fatigue, constant coughing, breathing abnormally, and vomiting — the latter of which “is important, and occurs in about 60 percent” of secondary drowning cases, according to Gillespie.

Other changes in behavior, like acting out of character or soiling themselves, should also be noted.

Dangers By Setting

In addition to presentation, Gillespie says, drowning sites have dangers that are setting-specific. A lake drowning episode, for example, usually involves different factors than a hot-tub incident.

“With lakes and other bodies of water, there’s often alcohol involved; the victim falls into the water, and there’s trauma,” she says. “For instance, the lake may be 30 feet deep, but if there’s a log six feet down, that can be problem” as the person can be knocked unconscious or injured.

Any place with pooling water can present danger, especially for children. Gillespie says that roughly 55 percent of infant drowning deaths occur in bathtubs, and it is not uncommon for babies under the age of 1 to die after being submerged in a large bucket. In swimming pools, hot tubs and spas, beware especially of suctions that can trap hair, and overcrowding, because struggling kids can slip underwater without being noticed.

Related: 17-Year-Old Diagnosed with Rare Allergy to Water — Yes, Water

Perhaps most importantly, do not let your guard down in a familiar setting. “The majority of pediatric drownings happen at home,” says Gillespie. Home can give one a false sense of security.

“The Story is Always the Same”

Home drowning dangers are very real, but also preventable. Gillespie says to always make sure pool gates are locked and fences are high enough (at least 4 feet). Put alarms on doors so that you know if a child gets into the pool area unaccompanied, and have taut pool covers to keep little ones from falling in.

“You must have layers of protection,” she explains. “If kids are wily, they will get into the pool area. Just knowing how to swim is not enough. And if a child ever goes missing? It sounds morbid, but you need to check the pool area first.”

Gillespie says there is a similar storyline in so many of the at-home drowning deaths she has had the misfortune of witnessing.

A pool, a summer day, a young child and at least two adults. Each thinks the other is watching the child, but curiosity leads the little one toward a fence that he or she quietly scales, or to a gate left unlocked that the child walks through. There is an inaudible splash. Something begins to feel off; almost at the same moment, the adults realize the child is missing.

“That’s the sad thing,” says Gillespie. “The story is always the same.”

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